Comparative analysis between diagnostic categories of a single-center vs. European Liver Transplant Registry (ELTR).

Introduction - The European Liver Transplant Registry (ELTR) currently represents the most widely dataset concerning liver transplantation (LT) activity available in Europe. The last ELTR report included 44,286 LT performed on 39,196 patients from January 1988 to December 2001 [1]. Our Department is involved from 1996 in the ELTR data collection. Methods - ELTR codes (n=46) were assigned to clinical diagnostic categories reported in the last ELTR analysis. In our Department, in the period January1, 2000 - August 31, 2003, 160 LT in 137 patients were performed. The patients were in 15 different ELTR diagnostic categories. Results - In the ELTR analysis, 1-year patient survival (1yr-PtSurv) and 1-year graft survival (1yr-GrSurv) was 83% and 76%, respectively. In our series, 1yr-PtSurv and 1yr-GrSurv was 77.78% and 72.99%, respectively. Inter-rate agreement between ELTR vs. our Department ELTR diagnostic codes was poor (k = 0.325; Passing-Bablock regression, P<0.01). In our series, by considering only ELTR codes that were >1% with respect to the whole diagnostic categories (88.26% for our series, 53.2% with respect to ELTR series), no significance occurred in Passing-Bablock regression (P>0.10). Following this approach, in the ELTR series 1yr-PtSurv and 1yr-GrSurv was 82.25% and 79.65%, respectively, while in our series 1yr-PtSurv and 1yr-GrSurv was 82.84% and 81.38%, respectively. Conclusions - The comparison between ELTR and single-center results required appropriate comparative procedures concerning patient diagnostic categories, in order to avoid the risk of a biased assessment about liver transplantation quality at the single-center level. References - [1]. Adam R. et al. Liver Transplantation 9:1231-1243 (2003).